Individual
DR. NICHOLAS JOHN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
19 DAVIS AVE FL 4, NEPTUNE CITY, NJ 07753-4488
(732) 212-6598
Mailing address
19 DAVIS AVE FL 4, NEPTUNE CITY, NJ 07753-4488
(732) 212-6598
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
25MA11351700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
03/29/2017
Last updated
07/28/2025
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